Enzyme-Targeted Therapeutics for Neurological Disorders

Neurological disorders represent one of the leading causes of disability and mortality worldwide, and their prevalence is expected to increase substantially with population aging. Despite major advances in neuroscience, effective disease-modifying therapies remain unavailable for most chronic disorders of the central nervous system (CNS), highlighting the need for novel therapeutic strategies. Enzymes are attractive drug targets because they regulate fundamental processes including neurotransmission, signal transduction, energy metabolism, protein homeostasis, epigenetic regulation, lipid metabolism, and cellular detoxification. This review summarizes the major classes of druggable CNS enzymes, discuss clinically approved drugs and emerging investigational agents, and evaluate therapeutic opportunities across neurodegenerative, neurodevelopmental, neuropsychiatric, cerebrovascular, and neuro-oncologic diseases. Key challenges including blood-brain barrier penetration, target selectivity, off-target pharmacology, and clinical translation are also examined. By integrating diverse enzyme-targeting modalities across multiple neurological disorders, this review highlights both the progress achieved to date and the substantial opportunities that remain for future CNS drug discovery.